{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T06:12:15Z","timestamp":1792735935848,"version":"4.5.0"},"update-to":[{"DOI":"10.1371\/journal.pntd.0011959","type":"new_version","label":"New version","source":"publisher","updated":{"date-parts":[[2024,12,23]],"date-time":"2024-12-23T00:00:00Z","timestamp":1734912000000}}],"reference-count":42,"publisher":"Public Library of Science (PLoS)","issue":"11","license":[{"start":{"date-parts":[[2024,11,21]],"date-time":"2024-11-21T00:00:00Z","timestamp":1732147200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000865","name":"Bill and Melinda Gates Foundation","doi-asserted-by":"publisher","award":["OPP1155293"],"award-info":[{"award-number":["OPP1155293"]}],"id":[{"id":"10.13039\/100000865","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100009830","name":"Margaret A. Cargill Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100009830","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000865","name":"Bill and Melinda Gates Foundation","doi-asserted-by":"publisher","award":["OPP1177824"],"award-info":[{"award-number":["OPP1177824"]}],"id":[{"id":"10.13039\/100000865","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000865","name":"Bill and Melinda Gates Foundation","doi-asserted-by":"publisher","award":["INV- 005121"],"award-info":[{"award-number":["INV- 005121"]}],"id":[{"id":"10.13039\/100000865","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosntds.org"],"crossmark-restriction":false},"short-container-title":["PLoS Negl Trop Dis"],"abstract":"<jats:p>Gambiense human African trypanosomiasis (gHAT), a neglected tropical disease caused by a parasite transmitted by tsetse flies, once inflicted over 30,000 annual cases and resulted in an estimated half a million deaths in the late twentieth century. An international gHAT control program has reduced cases to under 1,000 annually, encouraging the World Health Organization to target the elimination of gHAT transmission by 2030. This requires adopting innovative disease control approaches in foci where transmission persists. Since the last decade, case detection and treatment, the mainstay of controlling the disease, is supplemented by vector control using Tiny Targets, small insecticide-treated screens, which attract and kill tsetse. The advantages of Tiny Targets lie in their relatively low cost, easy deployment, and effectiveness. The Democratic Republic of Congo (DRC), bearing 65% of the 799 gHAT cases reported globally in 2022, introduced Tiny Targets in 2015. This study estimates the annual cost of vector control using Tiny Targets in the health district of Yasa Bonga in the DRC and identifies the main cost drivers. Economic and financial costs, collected from the provider\u2019s perspective, were used to estimate the average cost of tsetse control expressed as cost (i) per target used, (ii) per target deployed, (iii) per linear kilometre of river controlled, and (iv) per square kilometre protected by vector control. Sensitivity analyses were conducted on key parameters for results robustness.<\/jats:p>\n<jats:p>The estimated annual economic cost for protecting an area of 1,925 km<jats:sup>2<\/jats:sup> was 120,000 USD. This translates to 5.30 USD per target used each year, 11 USD per target deployed in the field, 573 USD per linear km treated, and 62 USD per km<jats:sup>2<\/jats:sup> protected. These costs in the DRC are comparable to those in other countries. The study provides valuable information for practitioners and policymakers making rational, evidence-based decisions to control gHAT.<\/jats:p>","DOI":"10.1371\/journal.pntd.0011959","type":"journal-article","created":{"date-parts":[[2024,11,21]],"date-time":"2024-11-21T18:57:44Z","timestamp":1732215464000},"page":"e0011959","update-policy":"https:\/\/doi.org\/10.1371\/journal.pntd.corrections_policy","source":"Crossref","is-referenced-by-count":4,"title":["The cost of sleeping sickness vector control in Yasa Bonga, a health district in the Democratic Republic of the Congo"],"prefix":"10.1371","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2432-9818","authenticated-orcid":true,"given":"Rian","family":"Snijders","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandra P. M.","family":"Shaw","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard","family":"Selby","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Inaki","family":"Tirados","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul R.","family":"Bessell","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alain","family":"Fukinsia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erick","family":"Miaka","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabrizio","family":"Tediosi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Epco","family":"Hasker","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marina","family":"Antillon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2024,11,21]]},"reference":[{"issue":"10110","key":"pntd.0011959.ref001","doi-asserted-by":"crossref","first-page":"2397","DOI":"10.1016\/S0140-6736(17)31510-6","article-title":"Human African trypanosomiasis","volume":"390","author":"P Buscher","year":"2017","journal-title":"Lancet (London, England)."},{"key":"pntd.0011959.ref002","volume-title":"Factsheet: Trypanosomiasis, human African (sleeping sickness)","author":"World Health Organization (WHO).","year":"2023"},{"key":"pntd.0011959.ref003","volume-title":"Global Health Observatory data repository: Number of new reported cases (T.b. gambiense):2022","author":"World Health Organization (WHO)","year":"2023"},{"key":"pntd.0011959.ref004","first-page":"257","article-title":"Epidemiology of human African trypanosomiasis.","volume":"6","author":"JR Franco","year":"2014","journal-title":"Clin Epidemiol."},{"issue":"6","key":"pntd.0011959.ref005","doi-asserted-by":"crossref","first-page":"748","DOI":"10.1017\/S0031182013002102","article-title":"The journey towards elimination of gambiense human African trypanosomiasis: not far, nor easy","volume":"141","author":"JR Franco","year":"2014","journal-title":"Parasitology"},{"key":"pntd.0011959.ref006","volume-title":"Accelerating work to overcome the global impact of Neglected topical diseases: A Roadmap for implementation (WHO\/HTM\/NTD\/2012.1).","author":"World Health Organization (WHO)","year":"2012"},{"issue":"1","key":"pntd.0011959.ref007","doi-asserted-by":"crossref","first-page":"e0010047","DOI":"10.1371\/journal.pntd.0010047","article-title":"The elimination of human African trypanosomiasis: Achievements in relation to WHO road map targets for 2020.","volume":"16","author":"JR Franco","year":"2022","journal-title":"PLOS Neglected Tropical Diseases"},{"issue":"3","key":"pntd.0011959.ref008","doi-asserted-by":"crossref","first-page":"197","DOI":"10.1016\/j.pt.2017.11.008","article-title":"Do Cryptic Reservoirs Threaten Gambiense-Sleeping Sickness Elimination?","volume":"34","author":"P B\u00fcscher","year":"2018","journal-title":"Trends Parasitol"},{"issue":"6","key":"pntd.0011959.ref009","first-page":"707","article-title":"Contemporary and emerging strategies for eliminating human African trypanosomiasis due to Trypanosoma brucei gambiense: review. Tropical Medicine &","volume":"20","author":"P Steinmann","year":"2015","journal-title":"International Health"},{"issue":"4","key":"pntd.0011959.ref010","doi-asserted-by":"crossref","first-page":"e0003686","DOI":"10.1371\/journal.pntd.0003686","article-title":"From health advice to taboo: community perspectives on the treatment of sleeping sickness in the Democratic Republic of Congo, a qualitative study.","volume":"9","author":"A Mpanya","year":"2015","journal-title":"PLoS Neglected Tropical Diseases"},{"key":"pntd.0011959.ref011","first-page":"3","article-title":"Is vector control needed to eliminate gambiense human African trypanosomiasis","author":"P Solano","year":"2013","journal-title":"Front Cell Infect Microbiol"},{"key":"pntd.0011959.ref012","unstructured":"World Health Organization (WHO). Control and surveillance of human African trypanosomiasis, WHO technical report series (984). Geneva: WHO, 2013 0512\u20133054 (Print) 0512\u20133054 Contract No.: 984."},{"issue":"10","key":"pntd.0011959.ref013","doi-asserted-by":"crossref","first-page":"e0008270","DOI":"10.1371\/journal.pntd.0008270","article-title":"Impact of tiny targets on Glossina fuscipes quanzensis, the primary vector of human African trypanosomiasis in the Democratic Republic of the Congo.","volume":"14","author":"I Tirados","year":"2020","journal-title":"PLOS Neglected Tropical Diseases"},{"issue":"4","key":"pntd.0011959.ref014","first-page":"451","article-title":"La lutte contre la trypanosomiase humaine africainedans le foyer de Luba en Guinee equatoriale: bilan de trois methodes","volume":"69","author":"PP Simarro","year":"1991","journal-title":"Bulletin of the World Health Organization"},{"issue":"6","key":"pntd.0011959.ref015","first-page":"697","article-title":"La lutte contre les vecteurs de la maladie du sommeil \u00e0 Trypanosoma gambiense Dutton.","volume":"38","author":"A Challier","year":"1978","journal-title":"Med Trop (Mars)."},{"key":"pntd.0011959.ref016","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pntd.0003727","article-title":"Reducing human-tsetse contact significantly enhances the efficacy of sleeping sickness active screening campaigns: A promising result in the context of elimination.","volume":"9","author":"F Courtin","year":"2015","journal-title":"PLoS Neglected Tropical Diseases."},{"issue":"3","key":"pntd.0011959.ref017","doi-asserted-by":"crossref","first-page":"e0003624","DOI":"10.1371\/journal.pntd.0003624","article-title":"Costs of using \u201ctiny targets\u201d to control glossina fuscipes fuscipes, a vector of gambiense sleeping sickness in Arua district of Uganda.","volume":"9","author":"APM Shaw","year":"2015","journal-title":"PLoS Neglected Tropical Diseases"},{"issue":"8","key":"pntd.0011959.ref018","doi-asserted-by":"crossref","first-page":"e0003822","DOI":"10.1371\/journal.pntd.0003822","article-title":"Tsetse Control and Gambian Sleeping Sickness; Implications for Control Strategy.","volume":"9","author":"I Tirados","year":"2015","journal-title":"PLOS Neglected Tropical Diseases."},{"issue":"6","key":"pntd.0011959.ref019","doi-asserted-by":"crossref","first-page":"e0009404","DOI":"10.1371\/journal.pntd.0009404","article-title":"Use of vector control to protect people from sleeping sickness in the focus of Bonon (C\u00f4te d\u2019Ivoire).","volume":"15","author":"D Kaba","year":"2021","journal-title":"PLOS Neglected Tropical Diseases"},{"issue":"6","key":"pntd.0011959.ref020","doi-asserted-by":"crossref","first-page":"e0010222","DOI":"10.1371\/journal.pntd.0010222","article-title":"Scaling up of tsetse control to eliminate Gambian sleeping sickness in northern Uganda.","volume":"16","author":"A Hope","year":"2022","journal-title":"PLoS Negl Trop Dis"},{"issue":"7","key":"pntd.0011959.ref021","doi-asserted-by":"crossref","first-page":"e0005792","DOI":"10.1371\/journal.pntd.0005792","article-title":"Adding tsetse control to medical activities contributes to decreasing transmission of sleeping sickness in the Mandoul focus (Chad).","volume":"11","author":"MH Mahamat","year":"2017","journal-title":"PLoS Negl Trop Dis"},{"issue":"1","key":"pntd.0011959.ref022","doi-asserted-by":"crossref","first-page":"e0005162","DOI":"10.1371\/journal.pntd.0005162","article-title":"Predicting the Impact of Intervention Strategies for Sleeping Sickness in Two High-Endemicity Health Zones of the Democratic Republic of Congo.","volume":"11","author":"KS Rock","year":"2017","journal-title":"PLoS Negl Trop Dis."},{"key":"pntd.0011959.ref023","unstructured":"World Health Organization (WHO). Improving health system efficiency: Democratic Republic of the Congo: improving aid coordination in the health sector. Geneva: World Health Organization, 2015 2015. Report No.: Contract No.: WHO\/HIS\/HGF\/CaseStudy\/15.4."},{"key":"pntd.0011959.ref024","unstructured":"Mubwa Mungwele N. Rapport annuel 2017: Yasa Bonga. Yasa Bonga: 2018."},{"key":"pntd.0011959.ref025","unstructured":"PNLTHA. Database HAT cases: 2013\u20132017. In: PNLTHA, editor. Kinshasa, DRC2017."},{"key":"pntd.0011959.ref026","unstructured":"Snijders, R. (2024). Scaling up of vector control in the health district of Yasa Bonga. Zenodo. https:\/\/doi.org\/10.5281\/zenodo.13342409"},{"key":"pntd.0011959.ref027","year":"2023","journal-title":"QGIS Development TeamQGIS Geographic Information System. 3.28.9-Firenze ed: QGIS Association"},{"issue":"1","key":"pntd.0011959.ref028","first-page":"61","article-title":"The pyramidal trap for collecting and controlling tsetse flies (Diptera: Glossinidae). Comparative trials and description of new collecting technics","volume":"37","author":"JP Gouteux","year":"1986","journal-title":"Trop Med Parasitol"},{"issue":"2","key":"pntd.0011959.ref029","article-title":"An Overview of Value, Perspective, and Decision Context-A Health Economics Approach: An ISPOR Special Task Force Report [2].","volume":"21","author":"LP Garrison","year":"2018","journal-title":"Value Health"},{"issue":"1","key":"pntd.0011959.ref030","doi-asserted-by":"crossref","first-page":"340","DOI":"10.1186\/s13071-018-2922-5","article-title":"The development of high resolution maps of tsetse abundance to guide interventions against human African trypanosomiasis in northern Uganda","volume":"11","author":"MC Stanton","year":"2018","journal-title":"Parasit Vectors"},{"issue":"1","key":"pntd.0011959.ref031","doi-asserted-by":"crossref","first-page":"e0010033","DOI":"10.1371\/journal.pntd.0010033","article-title":"The cost of tsetse control using \u2018Tiny Targets\u2019 in the sleeping sickness endemic forest area of Bonon in C\u00f4te d\u2019Ivoire: Implications for comparing costs across different settings.","volume":"16","author":"F Courtin","year":"2022","journal-title":"PLOS Neglected Tropical Diseases"},{"issue":"1","key":"pntd.0011959.ref032","doi-asserted-by":"crossref","first-page":"419","DOI":"10.1186\/s13071-020-04286-w","article-title":"Delivering \u2019tiny targets\u2019 in a remote region of southern Chad: a cost analysis of tsetse control in the Mandoul sleeping sickness focus.","volume":"13","author":"JB Rayaisse","year":"2020","journal-title":"Parasit Vectors."},{"key":"pntd.0011959.ref033","article-title":"Methods for The economic evaluation of health care programmes fourth edition: Oxford","author":"MF Drummond","year":"2015"},{"key":"pntd.0011959.ref034","volume-title":"Cost analysis in primary health care: a training manual for programme managers.","author":"D. Creese AP","year":"1995"},{"key":"pntd.0011959.ref035","article-title":"CHOosing Interventions that are Cost Effective (WHO-CHOICE): Table 4: Capital Item\u2014Useful Lives Reported by Country Experts Geneva: WHO","author":"World Health Organization (WHO)","year":"2008"},{"issue":"2","key":"pntd.0011959.ref036","doi-asserted-by":"crossref","first-page":"127","DOI":"10.1093\/heapol\/czh015","article-title":"Cost and unit cost calculations using step-down accounting.","volume":"19","author":"L Conteh","year":"2004","journal-title":"Health policy and planning."},{"key":"pntd.0011959.ref037","article-title":"HAT Modelling and Economic Predictions for Policy (HAT MEPP)","author":"KS Rock","year":"2023"},{"issue":"9","key":"pntd.0011959.ref038","doi-asserted-by":"crossref","first-page":"e1332","DOI":"10.1371\/journal.pntd.0001332","article-title":"Towards an optimal design of target for tsetse control: Comparisons of novel targets for the control of palpalis group tsetse in west Africa.","volume":"5","author":"JB Rayaisse","year":"2011","journal-title":"PLoS Neglected Tropical Diseases"},{"issue":"9","key":"pntd.0011959.ref039","doi-asserted-by":"crossref","first-page":"e0008696","DOI":"10.1371\/journal.pntd.0008696","article-title":"Feasibility of community-based control of tsetse: A pilot project using Tiny Targets in the Democratic Republic of Congo.","volume":"14","author":"C Vander Kelen","year":"2020","journal-title":"PLoS Negl Trop Dis"},{"key":"pntd.0011959.ref040","article-title":"Cost-effectiveness of end-game strategies against sleeping sickness across the Democratic Republic of Congo.","volume":"2024","author":"M. Antillon","journal-title":"medRxiv"},{"issue":"5","key":"pntd.0011959.ref041","doi-asserted-by":"crossref","first-page":"480","DOI":"10.1093\/inthealth\/ihab004","article-title":"Demonstrating the sustainability of capacity strengthening amidst COVID-19.","volume":"13","author":"P Abomo","year":"2021","journal-title":"Int Health."},{"key":"pntd.0011959.ref042","doi-asserted-by":"crossref","unstructured":"FAO and WHO.2022 Vector control and the elimination of gambiense human African trypanosomiasis (HAT)\u2014Joint FAO\/WHO Virtual Expert Meeting\u20145\u20136 October 2021. PAAT Meeting Report Series. No. 1. Rome. https:\/\/doi.org\/10.4060\/cc0178en","DOI":"10.4060\/cc0178en"}],"updated-by":[{"DOI":"10.1371\/journal.pntd.0011959","type":"new_version","label":"New version","source":"publisher","updated":{"date-parts":[[2024,12,23]],"date-time":"2024-12-23T00:00:00Z","timestamp":1734912000000}}],"container-title":["PLOS Neglected Tropical Diseases"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pntd.0011959","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,12,23]],"date-time":"2024-12-23T18:51:47Z","timestamp":1734979907000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pntd.0011959"}},"subtitle":[],"editor":[{"given":"Sergio","family":"Recuenco","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2024,11,21]]},"references-count":42,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2024,11,21]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pntd.0011959","relation":{"new_version":[{"id-type":"doi","id":"10.1371\/journal.pntd.0011959","asserted-by":"object"}]},"ISSN":["1935-2735"],"issn-type":[{"value":"1935-2735","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,11,21]]}}}